Prevalence of goitre among school children in Belgaum district

Assessment of iodine nutrition of schoolchildren in Gonda, India, indicates improvement and effectivity of salt iodisation

OBJECTIVE

To study the total goitre rate (TGR), urinary iodine concentration (UIC) and salt iodine content among schoolchildren in a previously endemic area for severe iodine deficiency disorder (IDD).

DESIGN

Cross-sectional epidemiological study.

SETTING

The study was carried out in the Gonda district (sub-Himalayan region) of North India.

PARTICIPANTS

Nine hundred and seventy-seven schoolchildren (6-12 years) were studied for parameters such as height, weight, UIC and salt iodine content. Thyroid volume (TV) was measured by ultrasonography to estimate TGR.

RESULTS

The overall TGR in the study population was 2·8 % (95 % CI 1·8, 3·8). No significant difference in TGR was observed between boys and girls (3·5 % v. 1·9 %, P = 0·2). There was a non-significant trend of increasing TGR with age (P = 0·05). Median UIC was 157·1 μg/l (interquartile range: 94·5-244·9). At the time of the study, 97 % of salt sample were iodised and nearly 86 % of salt samples had iodine content higher than or equal to 15 part per million. Overall, TGR was significantly lower (2·8 % v. 31·0 %, P < 0·001), and median UIC was significantly higher (157·1 v. 100·0 μg/l, P < 0·05) than that reported in the same area in 2009.

CONCLUSIONS

A marked improvement was seen in overall iodine nutrition in the Gonda district after three and a half decades of Universal Salt Iodisation (USI). To sustainably control IDD, USI and other programmes, such as health education, must be continuously implemented along with putting mechanisms to monitor the programme at regular intervals in place.

Prevalence of goiter among children aged 8-10 in Binh Dinh province, Vietnam in 2016-2017

Objective

The study was conducted to estimate the goiter prevalence, and the median urine iodine concentrations among schoolchildren aged 8–10 in Binh Dinh province, Vietnam.

Methods

A school-based cross-sectional survey was carried out from May 2016 to May 2017. A multistage, proportional-to-population-size sampling method with 30 clusters was used. The children were examined by palpation for the presence or absence of goiter based on the criteria of the World Health Organization (WHO), the United Nations Children's Fund (UNICEF), International Council for the Control of Iodine Deficiency (ICCIDD); urinary iodine was determined in microplates by a modification of the Sandell-Kolthoff reaction. The Chi-square test was used to compare prevalences, and the Chi-square test for trend was employed to assess the trend of goiter prevalence and urine iodine levels by age and economic-social areas.

Results

1800 pupils from 8 to 10 years old including 900 males and 900 females were examined and 300 among them were tested for the urinary iodine concentration (UIC). The prevalence of goiter among schoolchildren was 6.6%. The prevalence of goiter tended to increase in areas with disadvantaged conditions, among which the urban areas occupied the lowest prevalence (5%) while the mountainous areas and Midland took the highest (8.8%) (the p-value of 0.0193). The median UIC of the study group was 159.9 µg/L; the 25^th and 75^th percentile value was 103 µg/L and 230.2 µg/L, respectively.

Conclusion

According to the WHO/UNICEF/ICCIDD classification, the goiter prevalence indicated that some regions of Binh Dinh province appeared to be slightly affected by iodine deficiency. These have characterized an important public health challenge, highlighting the need to eliminate iodine deficiency disorders in these areas.

Prevalence of goiter and associated factors among schoolchildren in northeast Ethiopia

OBJECTIVES

Goiter is a major public health problem, especially in developing countries such as Ethiopia. Hence, this study aimed to assess the prevalence and associated factors of goiter among children in Waghimra Zone, northeast Ethiopia.

METHODS

A cross-sectional study was conducted from April 8 to 25, 2015 in northeast Ethiopia. A multistage sampling method was used to select 454 schoolchildren. Data were collected using a pre-tested structured interviewer-administered questionnaire. Children were examined for the presence or absence of goiter based on the criteria of the United Nations Children's Fund, International Council for the Control of Iodine Deficiency, and the World Health Organization. Salt samples from children's homes were tested for iodine levels using a rapid iodized salt test kit. Data were entered into EpiInfo version 7 and exported to SPSS version 20 for analysis. Bivariate and multivariate logistic regression models were fitted, and adjusted odds ratio (aOR) with 95% confidence interval (CI) were computed to determine the level of significance.

RESULTS

The prevalence of goiter was 62.1% (95% CI, 57.5 to 66.5%). Being female (aOR, 3.09; 95% CI, 1.57 to 6.08), having a family history of goiter (aOR, 5.18; 95% CI, 2.43 to 11.03), and using non-iodized salt (aOR, 2.20; 95% CI, 1.12 to 4.38) were factors associated with goiter among schoolchildren.

CONCLUSIONS

The prevalence of goiter was high. Being female and having a family history of goiter increased the risk of goiter in children, but using iodized salt was protective. Therefore, we recommend ensuring universal access to iodized salt and increasing the awareness of the community of the importance of iodized salt utilization.

Prevalence and Factors Associated with Goitre among 6-12-year-old Children in a Rural Area of Karnataka in South India

In India, endemic goitre is present in sub-Himalayan region and in pockets in states of Andhra Pradesh, Karnataka and Gujarat. Being a public health problem amenable for prevention, the assessment of prevalence of endemic goitre in an area helps in understanding whether the preventive strategies under National Iodine Deficiency Disorder Control Program (NIDDCP) have any impact on the control of endemic goitre. Hence, the current study was carried out to determine the prevalence, distribution and factors associated with iodine deficiency goitre among 6-12-year-old children in a rural area in south Karnataka. A cross-sectional study was conducted among 838 children, using a questionnaire adopted from Iodized Salt Program Assessment Tool and the tools prescribed by WHO for goitre survey. The prevalence of goitre in the study area was 21.9% (95% CI 19.2-24.8). There was higher prevalence of goitre among those having salt iodine <15 ppm than those with >15 ppm (P = 0.01; OR 1.59; 95% CI 1.10-2.29). In 10% of the children, urinary iodine excretion (UIE) was assessed and prevalence was higher among those with <100 μg/l of UIE than those with normal UIE, which was not statistically significant (P = 0.8, OR 1.36; 95% CI 0.62-2.96). Multiple logistic regression revealed that gender (P = 0.002; OR 1.7; 95% CI 1.21-2.35) was an independent variable associated with goitre. The study area was found to be moderately endemic for goitre based on the WHO criteria. Higher prevalence of goitre was found to be still associated with consumption of low iodized salt (<15 ppm) necessitating emphasis on monitoring of salt iodine levels in the study area. Though NIDDCP is being implemented since five decades in India, the burden of iodine deficiency disorders (IDDs) is still high demanding further impetus to the monitoring systems of the programme.